Despite the considerable research activity in the area of ethnicity and health, purchasers and providers in health care lack clear guidance on health care needs and service organisation. The literature suggests that although cultural, genetic and social factors are important in certain diseases, access to appropriate health services can appreciably relieve this burden of disease. However, Britain's ethnic minority populations are to be found principally in the poorer regions, and inner cities, where health services are least well developed. They may also be among the least able to take advantage of the existing services because of a variety of barriers to access, ranging from language and culture, to prejudiced views of service purchasers and providers, and discriminatory institutional practices.